News: regions.

Cape Verde's former president Pedro Verona Pires won the US$ 5 million (€ 3.8 million) “African leadership prize” awarded by the Mo Ibrahim Foundation. The prize was created in 2007, it is worth US$ 5 million (€ 3.8 million) over 10 years and then US$ 200 000 (€ 154 333) annually for life thereafter. Previous winners included Mozambique's former president Joaquim Chissano and Botswana’s Festus Gontebanye Mogae, while Nelson Mandela of South Africa was named an honorary laureate in 2007. This year the prize was given to Mr Pires for transforming his small country into a model of democracy and stability and then deciding to step down after his second term. Speaking for The Guardian, Salim Ahmed Salim, the chair of the prize committee, has said that “...under 10 years as president, the nation became only the second African country to graduate from the United Nation’s least-developed category and has won international recognition for its record on human rights and good governance”. Pires was appointed first prime minister of independent Cape Verde in 1975, and he remained in this post for 16 years. He lost his country's first democratic elections in 1991, but was elected again in 2001 and then re-elected in 2006. For the past two years the Foundation, set up by a Sudan-born billionaire Mo Ibrahim, did not award a prize as no leaders met the criteria for promoting development and democracy and for handing over power peacefully.

 Vaccine introduction reduced pneumonia infections in Kenya by more than two-thirds In a recent study, conducted by the Kenya Medical Research Institute Wellcome Trust Research Programme, pneumonia infections in Kilifi, Kenya, have dropped by 70% since the introduction of the pneumococcal vaccine.
Earlier this year, in February 2011, Kenyan president Mwai Kibaki made the pneumococcal vaccine available to all Kenyan children. The vaccine is now freely available in about 3200 health facilities across Kenya that offer immunization. The vaccine targets infants in their first year of life and is given in three doses. Beth Mugo, a minister for public health, urged mothers to ensure that their children have the course completed to prevent resistance to the vaccine. This is of particular importance because early data showed that more than 20% of the vaccinated children did not complete the full course. Annually, the government will be contributing 72 million Kenyan shillings for the vaccine introduction. As the vaccine is now available throughout the country, the local experts believe that the results of the study are indicative for the country as a whole.
 H3Africa aims to bring research capacity in genomics to the poorest continent H3Africa stands for the "Human Heredity and Health in Africa". This welcome initiative aims to facilitate a contemporary research approach to genetic and environmental determinants of common diseases, resulting in an improved health among African populations. This should be achieved through the development of the necessary expertise among African scientists, and also establishing networks of African investigators. Current genomic research in wealthy countries is focused on developing tools for early and more accurate diagnosis, the development of new drugs and, potentially, personalized medicine -which has become a term describing the idea of systematic use of information about each individual to select or optimize the care provided to each patient individually. However, most African countries are being left out of the ongoing genomic revolution. The sponsors behind this initiative are the African Society of Human Genetics, the National Institutes of Health in the USA and The Wellcome Trust in the UK.
 BMJ's publication on the cost of Africa's doctor brain drain appears flawed In 2010, the World Health Assembly adopted the first "Code of Practice on the International Recruitment of Health Personnel". The idea behind this code was to recognise problems associated with doctor migration, implications on health systems in low resource settings, and to call on wealthy countries to provide financial assistance to source countries affected by health worker losses. In late November this year, a study published by BMJ claimed Sub-Saharan African countries that invest in training doctors "have ended up losing US$ 2 billion as the expert clinicians leave home to find work in more prosperous developed nations", as Reuters subsequently reported. But only weeks later Michael Clemens from the Center for Global Development ridiculed the simplistic approach to that calculation, pro-viding six important arguments that all relate to the complexities of assessing the costs and benefits of highly skilled workers to their home nation -none of which had been considered in the original article, and all of which would probably entirely change the conclusions.

 Lead poisoning epidemic in Nigerian villages
United Nations reported that more than 40 villages in Nigeria have been presenting cases of lead poisoning and called for an increase in preventive measures. The World Health Organization (WHO) has been assisting the Nigerian Government in dealing with the epidemic. WHO recommended strengthening the capacity to diagnose and treat the illness and ensuring de-contamination. WHO also warned about mining practices which are thought to be causing the sickness, with ore processing activities and storage of ore materials too close to the villages, using the obsolete practices with produce too much dust, and failure to remove contaminated clothes and wash before returning home. Lead poisoning damages the nervous system and causes brain and blood disorders, with long-term and expensive treatment with chelating agents required, which eventually remove heavy metals from the body. According to WHO, children in several villages in Zamfara state already require chelation therapy. Since the problem was discovered last year, nearly US$ 2 million (€ 1.5 million) has been provided by the UN Central Emergency Response Fund (CERF) to WHO and UNICEF to provide treatment, train doctors, provide diagnoses and raise awareness about the hazards of lead.

 Asia
 Afghanistan's largest mortality survey highlights improved maternal health The Afghanistan Mortality Survey (AMS) was completed in 2010 as a part of the worldwide Demographic and Health Surveys (DHS) project. The survey showed a significant decrease in maternal mortality -to about 500 deaths per 100 000 live births. This is a truly significant decreasedown from 1800 per 100 000 live births in the UN' s 2005 report. The AMS report suggests the decrease could be linked to the increased levels of antenatal care received by pregnant women. In the 36-59 months preceding the survey, 57% of women received antenatal care from a skilled provider, which rose to 68% of all pregnancies over the 12 months prior to the AMS survey. However, the report concedes that there is still a lot of work to be done, especially in regards to access to health care for women. The report found that 70% of women highlighted lack of money and distance to health care facilities as major barriers to accessing antenatal care.
 MSF's outrage over CIA's fake vaccination campaign serving secret operations in Pakistan As revealed by The Guardian, the international medical aid charity Médecins Sans Frontières (MSF) have lashed out at the CIA for using "...a fake vaccination programme as a cover to spy on Osama bin Laden". MSF said that this epi-sode could threaten life-saving immunisation work around the world. The international medical aid charity added that this "...ploy used by US intelligence was a grave manipulation of the medical act". The CIA recruited a Pakistani doctor and health visitors before the operation that killed Bin Laden in Abbottabad, in northern Pakistan, to confirm that the al-Qaida leader was indeed living in the compound. The doctor set up a vaccination drive for Hepatitis B in the town, to gain entry to the Bin Laden compound and obtain DNA samples the residents. Speaking for the Guardian, a senior US government official defended the practice, saying that it had been intended as "...an actual vaccination campaign conducted by real medical professionals". Later in the year, a team from the non-governmental organisation Save the Children needed to evacuate from its operations site in Pakistan amid safety concerns.
 50 th anniversary of universal health care in Japan In April, Japan marked the 50 th anniversary of universal health care. Since its introduction, Japan became a leading nation in several health metrics, most notably longevity. To mark this anniversary, The Lancet published a series of six theme papers and eight comments by Japanese academics. According to The Lancet, as they describe Japan's actions and provide an opportunity to translate that experience to other settings, the invited theme papers resemble "...finely crafted netsuke (fasteners): both functional and provoking reflection".
 A study reminds of a less prominent cause of malaria The most common form of malaria in Africa, which is caused by Plasmodium malariae, has been the subject of intense research interest and investments of the Global Fund and other stakeholders. However, a less dangerous form of the disease -the one caused by Plasmodium vivax -is still very prevalent or endemic in large parts of South Asia and Latin America. Recently, a new global map of the P. vivax malaria parasite has been revealed. It showed that the disease is endemic in substantial parts of the world. Kevin Baird, a researcher working with the Eijkman-Oxford clinical research unit in Indonesia, said that all the new information increasingly showed that P. vivax was a bigger threat than generally thought. Primaquine is the only treatment for P. vivax, while all the current vaccine efforts are targeting P. falciparum.
 Bangladesh plans to immunize 90% of children with major vaccines by 2016 Among six large populous countries eligible for GAVI support, Bangladesh earned recognition as the best performer in immunization coverage, after reducing the number of unimmunized children by more than 50% over the past four years.

 Kevin Rudd summarizes four years of foreign policy achievements
In November this year, the federal government of Australia completed their fourth year in charge, which also included the decisions made on foreign policy. The present minister of foreign affairs, Mr Kevin Rudd, gave a speech to the Australian Institute of International Affairs, outlining the challenges faced, achievements and visions of his government' s foreign policy. The major focus of the speech was on the importance of Australia being positive, outward looking and globally engaged as a country. In his visions, Mr Rudd laid out 10 key goals to be focused on in Australia' s foreign policy. Mr Rudd mentioned how in 2006 and 2007 Australian support for the Global Alliance for Vaccines and Immunisations (GAVI) funded the vaccination of 500 000 children against disease and how his government supported the further vaccination of 1.1 million children by the end of 2010 and pledged to vaccinate further 7.7 million by 2015. Australia also committed heavily to the Global Partnership for Education, which resulted in over 2 million children being enrolled and completing primary education. Mr Rudd also gave notice to Australia having been one of the largest bilateral donors of humanitarian aid in the recent Horn of Africa crisis.
 Priority actions to tackle noncommunicable disease (NCD) pandemics In April, The Lancet published an important series of papers, led by Auckland-based Dr Robert Beaglehole on behalf of the Lancet' s NCD Action Group and NCD Alliance. The series was published ahead of the UN' s High-Level Meeting on Non-Communicable Diseases (NCDs). The authors proposed "...five overarching priority actions for the response to the crisis leadership, prevention, treatment, international cooperation, and monitoring and accountability and the delivery of five priority interventions: tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies". The priority criteria were their health effects, costeffectiveness, low costs of implementation, and political and financial feasibility. Tobacco control was seen as the most urgent priority, while an estimated global commitment of about US$ 9 billion (€ 7 billion) per year would be required to bring enormous benefits to social and economic development and to the health sector.  China raises poverty bar to US$ 1 a day, up from 32 cents China has taken the step of raising its poverty line to the UN' s recommended standard of US$ 1 (€ 0.8) a day. Before this move, the poverty line in China was set at 1196 yuan per year per resident, which was less than 32 US cents a day. For China, this means that the number of Chinese qualified as "poor" will suddenly increase by over 100 million -to about 128 million. All of those people will now become entitled to the government' s poverty alleviation program. This increase reflects a change in the financial might of China and their attitudes towards the poor. Before China' s rise as an economical power, its priorities in regards to the poor were restricted to adequately feeding and clothing the population. But as GDP per capita has risen (from about 858 yuan in 1985, when China started its economic reforms, to 30 000 yuan in 2010), the ability of China to support its massive population has increased. This rise in GDP, as the China Daily reported, means that China now has the means to broaden its welfare program beyond the basic needs. Improving the lives of its poorest citizens is now the key aim of the Chinese poverty alleviation program.

 Global Fund withholds nearly US$ 100 million intended for China's AIDS fight
The Global Fund to Fight AIDS, Tuberculosis and Malaria will discontinue funding support for HIV/AIDS programs in China. The Global Fund' s spokesman Jon Liden said in the Geneva that the organization would keep about US$ 95 million (€ 73 million) from the total of US$ 270 million (€ 208 million) in grant money that was originally intended for China. This move was decided after a considerable pressure from both donors and non-governmental organizations to either fully stop, or substantially reduce funding to China. Some of them quoted possible concerns over management of disbursed funds as part of the reason, while others wanted to see the increase in funding in low-income countries where AIDS is relatively much bigger problem, but which have far fewer resources to tackle it. Apparently, this Global Fund' s decision was not one-sided; it was made in consultation with Chinese officials.

 China vaccinates millions in western regions to contain polio outbreak
Chinese government moved to vaccinate more than 9 million people in western regions against polio amid an outbreak that left 17 paralyzed and one dead. China had been polio-free for eleven years before the new cases were reported in Xinjiang province. This outbreak exposed gaps in immunization coverage in this remote region, where access to health services is rather low. According to the WHO, the polio strain was probably introduced from Pakistan, which is bordering Xinjiang province and is also one of the four countries where polio remains endemic -along with India, Afghanistan and Nigeria.

 Drug-resistant tuberculosis rapidly spreading in Europe
The World Health Organization announced in September that "...drug-resistant forms of tuberculosis (TB) are spreading at an alarming rate in Europe". TB is currently a worldwide pandemic that kills around 1.7 million people a year. Cases of multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB) -where the infections are resistant to first-line and then second-line antibiotic treatments -are spreading fast, with about 440 000 new patients every year globally. Half of the 30 countries with the highest burden of MDR-TB are in the WHO' s European region. More than 80 000 MDR-TB new cases occur in the European region each year, which is nearly a fifth of the world' s total. Officially reported cases of XDR-TB increased six-fold between 2008 and 2009, with the rates highest in Eastern Europe and Central Asia. Treatment regimes for MDR-TB and XDR-TB can stretch into two or more years, costing up to US$ 16 000 (€ 12 000) in drugs alone and up to US$ 300 000 (€ 232 000) per patient in isolation hospital care. The risk of death from straightforward TB is about 7%, but it rises to nearly 50% among patients with drug-resistant forms.
 EU will discontinue aid to 19 middle-income countries from 2014 Economic crisis that grasped European continent will have consequences for the ability of the EU to aid other countries -especially given that some of them are already surpassing large EU economies. EU officials have decided that China and another 18 middle-income countries will no longer qualify to be the recipients of the European Commission' s Development Cooperation instrument. Under the European Commission's new principle of "differentiation", 19 middle-income countries whose GDP is now greater than 1% of global GDP will no longer be able to receive bilateral grant aid. Instead, they will benefit from possible new forms of partnership, which are being agreed.

 Dutch lab concerns health officials by mutating killer virus
Several high-level health officials from different countries expressed vigilance and concern after a Dutch laboratory managed to develop a mutant version of the deadly bird flu virus that is -for the first time -contagious among humans. A research team from Holland announced in September that it had created a mutant version of the H5N1 bird flu virus that could be spread among mammals. Later in the year, it has been revealed that the US government has paid scientists to try to understand how the deadly bird flu virus might mutate to become a bigger threat. Two laboratories -one in the US and one in Netherlands -apparently succeeded in understanding this. However, US federal officials then took the unprecedented step of asking the scientists who succeeded to restrain from publishing the details of their work.

 Russia plans aid for HIV-troubled eastern Europe and central Asia
According to Financial Times, Russia plans to offer aid to fight HIV in eastern European countries and central Asia. This move, which is seen by some analysts as Russia' s latest effort to restore some of its political influence among the former Soviet Union affiliates, should offer additional funding to tackle HIV in a region with the fastest continued HIV growth anywhere in the world. The infections have tripled over the past ten years and it is estimated that some 1.4 million people are now affected. Some journalists in recipient countries expressed concern that, with this welcome aid funding, Russia could also export its restrictive policies on HIV prevention methods.

 India
 National Rural Health Mission "a minor success" An official review of the Indian Government' s ambitious National Rural Health Mission described it as a "minor success", adding that the results have been heartening compared to past experience in public health programmes. Deployment of human resources in the health sector has improved modestly, even though huge gaps still existed before the primary health care system could be declared to be running optimally, the report concluded. The review panel recommended that if the gains from this programme were to be consolidated, a renewed commitment for at least another seven years would be essential. The report called for almost quadrupling the per capita allocation for the health sector during the 12th five-year-plan period.
 India makes steady progress in infant mortality reduction  Mysterious epidemic of deadly kidney disease spreads across Central America According to BBC News, a mysterious epidemic is affecting the population of Central America. Reportedly, it has become the second most important cause of death among men in El Salvador. In Nicaragua, it' s a bigger killer of men than HIV and diabetes added together. The epidemic extends beyond those two countries and it is prevalent along the Pacific coast of Central America, across six countries. Dr Victor Penchaszadeh, a clinical epidemiologist at Columbia University in the US and consultant to the Pan-American Health Organization on chronic diseases in Latin America, stated about this epidemic: "It is important that the chronic kidney disease (CKD) afflicting thousands of rural workers in Central America be recognized as what it is -a major epidemic with a tremendous population impact". Reportedly, El Salvador' s health minister recently called on the international community for help. Up to the quarter of the farming workers in the area seems to be suffering from the disease, which eventually kills them. Interestingly, most of those affected show no signs of high blood pressure or diabetes, which are the most common causes of CKD elsewhere in the world. Currently suspected risk factors that could be causing this kidney damage are the toxic chemicals -pesticides and herbicides -that are routinely used in agriculture in Latin America, but banned in the United States, Europe and Canada. However, the overuse of painkillers and alcohol abuse can also damage kidneys, and both are also prevalent among the affected population.

 United States grow increasingly concerned over biological weapons threat
Reporting on the Secretary of State Hillary Clinton' s visit to Geneva, Reuters wrote that the United States are now calling for closer international cooperation to prevent terrorist groups from developing or using biological weapons. In the era of exploding advances in genomic research of many living species, including potentially deadly viruses and bacteria, and widely commercially available technologies for genome manipulation, this threat is continuously growing. Ms Clinton was reported to have concluded: "Unfortunately, the ability of terrorists and other non-state actors to develop and use these weapons is growing. Therefore this must be a renewed focus of our efforts".